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A harsh funding regime that hasn't adapted to changing macroeconomic realities means the viability of large parts of the pharmacy sector is at risk unless the model changes. Very simply, across the sector, revenue has remained largely fixed while costs have increased significantly, making it impossible for many pharmacies to sustain their business models. The sector has seen the closure of more than 1,500 community pharmacies since 2015, with 700 of these closures occurring since 2021. Larger pharmacy operators such as Lloyds, Boots, and Rowlands have seen the biggest decline in numbers, with smaller businesses operating between one and five pharmacies now accounting for almost 50% of the sector. Despite rising inflation and business costs, the NHS pharmacy funding model has remained fixed. Over the period of the current Community Pharmacy Contractual Framework (CPCF) - 2019-2024 - pharmacies have experienced a 30% real terms cut in core funding leading to an annual shortfall of over £750 million, equivalent to £67,000 per pharmacy in England. The current CPCF is due to end in 2024, and there is still no arrangement in place for future funding, leading to delayed and inefficient spending decisions and hampering the ability of the sector to plan and attract much-needed investment.

The current funding and contractual framework for community pharmacy is not fit for purpose, the Health and Social Care Committee report has concluded, recommending a complete overhaul to reduce its complexity. Published today, the report highlighted the necessity for a new framework to ensure adequate funding and to prevent damaging cross-subsidy between clinical services and prescription dispensing, as is presently observed. The report revealed that community pharmacy funding has fallen by over 30 per cent in real terms since 2015, resulting in an annual shortfall of at least £67,000 per pharmacy for individual owners. More than 1,100 community pharmacies have closed since 2015, of which were serving the most deprived areas, it said. MPs on the committee have urged the government to address medicine shortages, warning that they could undermine flagship initiatives such as 'Pharmacy First' by eroding public confidence in pharmacists. "People living with type 2 diabetes, ADHD, epilepsy and cystic fibrosis, and those experiencing the menopause, have faced challenges accessing the vital medication they need. Many others are facing similar experiences.

As the general election campaign heats up, major political parties - including Labour, the Conservatives, the Liberal Democrats - have released their manifestos, detailing their plans and visions for the future of community pharmacy. While the Conservative Party promises to expand Pharmacy First initiative, Labour pledges support for small businesses, with plans to overhaul the business rates system. The Liberal Democrats' election manifesto commits to developing a fairer and more sustainable long-term funding model for pharmacies. Announcing their plans recently, Prime Minister Rishi Sunak stated that they are investing in community care services to secure the future of the NHS and make healthcare more accessible. The Conservatives plan to fund these initiatives by cutting NHS managerial positions back to pre-pandemic levels and halving the government's management consultancy expenditure.

With the UK General Election set for 4 July, pharmacy bodies are actively engaging with all political parties to secure support for the community pharmacy sector. They are pressing parties to address urgent issues such as pharmacy closures and medicine shortages. "The upcoming general election is a critical opportunity for us to strengthen supporters of community pharmacy in readiness for the new Parliament," said Janet Morrison, chief executive of Community Pharmacy England (CPE). She stressed the need for unity within the sector in advocating for community pharmacy and raising awareness of the issues with election candidates from all parties. As the general election approaches, CPE has called upon all political parties to support pharmacies by "introducing a long-term sustainable funding model and reviewing the medicines supply chain, including much-needed short-term relief measures."

Pharmacy First has demonstrated the enormous value of community pharmacy in providing accessible front-line care. However, pharmacists continue to face several challenges in delivering the service. "Pharmacy First is a success, but it needs proper support to reach its full potential," said Numark chairman Harry McQuillan. In the first year alone, community pharmacies in England delivered an incredible 2 million consultations, highlighting the vital role pharmacists and their teams play in supporting the NHS. "This significant number shows the high demand for accessible healthcare and the trust patients place in their local pharmacy teams. It's clear that when empowered, community pharmacy delivers," McQuillan told Pharmacy Business. Key challenges in providing the service While Numark members have embraced Pharmacy First, McQuillan pointed out several challenges that persist: "Workforce capacity continues to be a concern, with patient demand sometimes outpacing available resources. "The administrative burden, particularly around IT interoperability, data capture, and reimbursement processes, adds complexity." "Additionally, some geographical areas are still struggling with public awareness, meaning more work is needed to ensure patients understand when and how they can access Pharmacy First."

Released on Monday morning, the election manifesto shared by the Liberal Democrats pledges to "strengthen patients' rights" by tackling public health inequalities and providing early access to community services. The Liberal Democrats Party's manifesto promises to address the issues at both the "front and back doors" of the National Health Service (NHS), which the party claims has been plunged into crisis by the Conservatives. Pledging to invest in public health and early access to community services, the party aims to "work towards a fairer and more sustainable long-term funding model for pharmacies and build on the Pharmacy First approach to give patients more accessible routine services and ease the pressure on GPs." The pledge also includes making prescriptions for people with chronic mental health conditions free on the NHS, as part of a wider commitment to review the entire schedule of exemptions for prescription charges.

Over-the-counter (OTC) medicines can empower customers and pave the way for a sustainable healthcare future. By embracing OTC products, pharmacies can achieve greater freedom, stability, and enhanced profitability. In our exclusive interview with Anna Maxwell, founder and CEO of pioneering consumer healthcare company Maxwellia, we explore their game-changing pharmacy brands leading the way in self-care. Why pharmacies should embrace OTC medicines? There's never been a more critical time for pharmacies to lean into the OTC space. Right now, about 90 per cent of pharmacy income in the UK is tied to NHS funding-a model that's increasingly unsustainable.[1] We all value the NHS, but it simply can't afford to cover every treatment at the point of use indefinitely. If pharmacies could achieve even a modest shift in NHS reliance this would mean more freedom, stability, and profitability for the business. OTC medicines are the key to making that happen, offering a way to quickly provide, effective treatments that help customers while reducing the administrative and financial burdens on pharmacists.

The Department of Health and Social Care (DHSC) has notified Community Pharmacy England (CPE) that they will no longer be able to implement the new hub and spoke models from 1 January 2025 as initially planned. The delay comes after the General Election, which put the progress of these amendments on hold. The DHSC is currently briefing new ministers across all policy areas, including hub and spoke dispensing between different pharmacy owners. As this process will take time, the implementation will not proceed as originally scheduled. CPE has stated that it does not yet have a clear timeline and will provide an update to the sector once more information becomes available. Malcolm Harrison, CEO of the Company Chemists' Association (CCA), expressed disappointment over the continued delays in fulfilling commitments made in the 2019 contractual framework agreement to support pharmacies.

"We need to fix the front door to our NHS by investing in community pharmacy," asserts Daisy Cooper as more and more pharmacies "worry about the future of their business." Reflecting on the challenges faced by pharmacists during the pandemic, she emphasised their pivotal role in launching vaccination schemes across communities and the larger role pharmacies play in complementing traditional NHS facilities. Cooper recalls her collaboration with local pharmacies in St. Albans, where she worked hand in glove with them to address challenges faced by pharmacists to obtain information from NHS England regarding protocols and procedures. She told Pharmacy Business reporter that she had to work out something "hand in glove to help them get those vaccinated schemes up and running, as pharmacies were desperate to take part in the vaccination scheme" in her constituency. Describing their unique selling point (USP), Cooper emphasised the convenience and immediacy of pharmacies located in high street areas and warned that pharmacy closures "should be a real wake up call for the government."